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(197) Predicting opioid misuse with a brief screener of catastrophizing

      Opioid medications commonly are used to treat various pain related conditions and are often misused by patients. The Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R) has been utilized in health settings for predicting opioid medication misuse. This study, examined the utility of the Catastrophizing Subscale from the Single Item Form of the Coping Strategies Questionnaire (CSQ3 Catastrophizing Subscale -- “It is terrible and I feel it is never going to get better”) to predict risk for opioid misuse on the SOAPP-R relative to the full scale Pain Catastrophizing Scale (PCS). The single item Catastrophizing Scale of the CSQ was selected as a more clinically useful tool for primary care settings to identify a modifiable risk factor for misuse. Patients were a clinical sample of convenience who were referred by medical providers for screening for possible long term opioid therapy. Data on 119 patients were used to determine the predictive ability of CSQ3 on SOAP-R score for both high risk (SOAP-R ≥ 22), and overall SOAPP-R score. The AUC, area under the receiver operator curve, which measures the ability of a variable or model to predict a binary outcome, for High risk SOAP-R with respect to CSQ3 was 0.72, which implies large predictive ability. Additionally, CSQ3 has an R2 of 0.30 for continuous SOAPP-R, again suggesting good predictive utility. However, when compared to PCS, CSQ3 has less utility, partial R2 of 0.014. Thus, CSQ3 does a good job of predicating SOAPP-R but is not as effective as PCS. These findings suggest a single question assessing for Catastrophizing has both clinical utility as an easily administered, scored and interpreted screener and, empirical validity in health-based settings as an initial screen for elevated risk for opioid misuse in chronic pain samples.